4 October 2018
Source: Optometry Scotland
New terms for General Ophthalmic Services (GOS) came into force in Scotland on 1st October, following negotiations between the Scottish Government and Optometry Scotland.
The updates build on the recommendations made in The Community Eyecare Services Review report published in April 2017, more than 10 years after the introduction of free NHSfunded eye examinations in Scotland.
The new arrangements give optometrists and ophthalmic medical practitioners at the front line of eye care more freedom to make decisions based on individual patient needs, moving away from a ‘tick box’ approach and offering more person-centred care.
As part of the changes, Optometry Scotland has also negotiated a fee of £38 for the newly introduced Enhanced Supplementary Eye Examination (ESEE) where a practitioner considers dilation clinically necessary. This is higher than the Supplementary Eye Examination (SEE) fee of £24.50 where the patient is not dilated.
This ESEE fee now recognises the significant time needed by community eye care professionals to deliver a dilated supplementary examination.
A summary of the main changes can be found here.
These include: Revised maximum frequencies and early re-examination codes for certain Primary Eye Examinations (PEEs), with stipulation that practitioners can examine patients in these categories more frequently and claim for an SEE or ESEE if they deem it clinically necessary; Revised reason codes and fee structure for (E)SEEs, reflecting an increased fee for supplementary examinations to better account for chair time required;
Revised mandatory tests and procedures for PEEs and (E)SEEs, allowing the practitioner to carry out the tests and procedures required based on individual patient signs, symptoms and needs;
Revised requirements for equipment provision and record keeping;
Increases to Continuing Education and Training (CET) allowances and changes to the application process;
Clarification of tests, procedures and examinations outwith GOS;
Increased grant paid to supervisors of pre-registration trainees.
Samantha Watson, Chair of Optometry Scotland, said: “A major change represented by these regulations is the move away from a ‘tick box’ approach when carrying out examinations.
“The updates encourage practitioners to exercise their professional judgement based on the patient’s presenting signs, symptoms and needs to determine the tests and procedures which they deem clinically necessary.
“This is a huge step forward in allowing us to deliver person-centred care. “Optometry Scotland particularly welcomes the newly introduced ESEE reason codes and fee structure which we have negotiated to better reflect the time and attention these patients require.
“We have negotiated with the Scottish Government extensively on these amendments and are encouraged to see further moves towards community optometry being the first port of call for all eye-related problems in Scotland.
“Work is ongoing to effectively deliver and improve General Ophthalmic Services in Scotland. We look forward to continuing collaboration with the Scottish Government and the progression of discussions for a further fee increase in April 2019, as well as overall GOS funding.”
Health Secretary Jeane Freeman said: “These positive changes to General Ophthalmic Services demonstrate our continued commitment to delivering safe, high quality and person-centred health care. They embed the role of the community optometrist as the first port of call for all eye-related matters in Scotland. We look forward to continuing to work with Optometry Scotland and other partners to make further improvements to GOS, as we continue to deliver on the recommendations of the Community Eyecare Services Review.”
Optometry Scotland is keen to highlight to practitioners the welcome revised Enhanced SEE reason codes and fee structure:
Enhanced SEE for those patients who require dilation;
2.9 code to be used when providing advice and counselling following an eye examination when the patient is being considered for cataract referral;
3.0 code for an additional appointment to complete a Primary Eye Examination where the patient has complex needs.
OS also wishes to draw attention to the fact that a cycloplegic refraction of a child will attract the Enhanced SEE fee and there will be a mechanism in place to backdate this increase to 1st April 2018.
Practitioners should note that the maximum frequency has been revised to every two years instead of one year for patients with glaucoma, patients with a family history of glaucoma and patients with ocular hypertension.
However, practitioners are reminded that where they judge that it is clinically necessary to examine patients in these categories more frequently than two years an examination can be conducted and a (E)SEE claimed using 2.3 or 4.3.
A revised GOS Statement is being issued to the profession along with the accompanying PCA.
In addition, Optometry Scotland will host a series of roadshows with PSD across Scotland later in the year, where the profession will have an opportunity to discuss and learn more about these changes.
More information can be found at http://www.optometryscotland.org.uk